NEJM Article on Ending Breast Cancer Screening Programs Incomplete and Should Concern American Women

The NEJM authors'' claim that mammography does not save many lives through early detection of tumors is false. According to National Cancer Institute data, since mammography screening became widespread in the mid-1980s, the U.S. breast cancer death rate, unchanged for the previous 50 years, has dropped well over 30 percent. Recent randomized control trials, particularly the largest and longest running breast cancer screening studies in history respectively, have reconfirmed that regular mammography screening cut breast cancer deaths by roughly a third (not the 20 percent cited by Andorno and Jüni) in all women ages 40 and over - including women ages 40-49. A study published in Cancer Epidemiology, Biomarkers & Prevention shows mammography screening cuts the risk of dying from breast cancer nearly in half. A recent study published in Cancer showed that more than 70 percent of the women who died from breast cancer in their 40s at major Harvard teaching hospitals were among the 20 percent of women who were not being screened. When discussing doing away with screening programs that have been proven to save thousands of lives each year, this information is important.

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The NEJM authors point to the Canadian National Breast Screening Study (CNBSS) to support claims of overdiganosis and lack of mammography effectiveness. Balanced information that the CNBSS has been widely discredited is not included. The World Health Organization long ago excluded the CNBSS from its analyses of screening mammography''s impact of breast cancer mortality. In a recent interview with CNN, the American Cancer Society echoed methodological concerns about the study. Breast cancer groups, such as BreastCancer.org, have also criticized this study and warned against following the author''s recommendations.

Medical science, at present, cannot determine which cancers will advance to kill a woman and which will not. As recently covered in the New York Times, estimates of overdiagnosis or overtreatment are not based on data regarding real patients, but are guesses based on population data that may be wildly off-mark. A recent rticle published in The Oncologist shows that many studies regarding overdiagnosis and potential harms of mammography are not well-founded and that their conclusions cannot be taken as fact. Yet, the NEJM authors advocate that widespread screening programs be ended, resulting in thousands of unnecessary deaths each year, based on such guesses. The ACR and SBI cannot support such a step.

Every major American medical organization with expertise in breast cancer care, including the American Congress of Obstetricians and Gynecologists ,American Cancer Society, American College of Radiology, National Accreditation Program for Breast Centers and Society of Breast Imaging recommend that women start getting annual mammograms at age 40. The ACR and SBI continue to stand by these recommendations.

Mammography can detect cancer early when it''s most treatable and can be treated less invasively - which not only save lives, but helps preserve quality of life. For more information regarding the proven effectiveness of regular mammography screening at reducing breast cancer deaths, please visit www.MammographySavesLives.org.

Contact Shawn Farley at 703-648-8936 or PR@acr.org to arrange an interview with a spokesperson.

Contact Catherine Dexter at 703-476-7485 or cdexter@sbi-online.org to arrange an interview with an SBI spokesperson.



Source: Newswise